Subthreshold PTSD

I like to talk about mental illness on this blog and my personal struggles with mental health. But let’s be clear: I’m not technically mentally ill. I’m in a weird gray area, because I have symptoms of PTSD but it’s not serious enough for a diagnosis. Recently I found out that there’s an unofficial name for this: subthreshold PTSD.

Mental health professionals use the Diagnostic and Statistical Manual (DSM) to determine whether someone has a mental illness. The diagnostic criteria for PTSD are listed below as well as my experiences with said symptoms.

Be exposed to trauma. They can experience it firsthand, witness it or learn that a loved one experienced trauma.
I’ve experienced sexual assault many times.

Persistently re-experience this trauma through intrusive thoughts, nightmares, flashbacks, or emotional distress and physical reactivity when reminded of what happened.
Uh, yep. I have PTSD-like episodes all the time (flashbacks, emotional distress and physical reactivity in the form of getting tense and short of breath). I have intrusive thoughts many times every day. I also used to have nightmares, but rarely have in the last year.

Avoid things that remind them of the trauma.
…Not so much. But this is mostly out of a combination of pure determination, overestimating myself and a dash of spite. I don’t want my past experiences to have the power to take away things that I love. I get triggered often during side hugs and while swing dancing. I still do those things. However, I sometimes postpone reading articles about sexual assault when my mental health isn’t stellar. But I tend to ignore my limits or overestimate myself.

Have negative thoughts or feelings that began or worsened after the trauma. For example, inability to recall key features of the trauma, overly negative thoughts and assumptions about oneself or the world, exaggerated blame of self or others for causing the trauma, decreased interest in activities, feeling isolated or difficulty experiencing happiness.
Not so much. I remember what happened vividly for the most part (I almost wish I didn’t). I don’t think super negatively about myself usually. I don’t blame myself. I do blame the people who did this to me, but that’s completely warranted. I’m still passionate about a great many things. I’m still happy. And I try to remain connected with those I love. So no, I don’t think I reach this criteria at all.

Experience hyperarousal. For example, irritability or aggression, risky or destructive behavior, hypervigilance, heightened startle reaction, difficulty concentrating or difficulty sleeping.
I experience hypervigilance (especially when walking alone at night) and a heightened startle reaction. I go into fight/flight/freeze very easily when triggered. When my mental health is struggling, I have difficulty concentrating and sleeping.

Symptoms lasting more than a month.
I’ve experienced this since 2013.

Symptoms that create distress or interfere with a person’s day to day life.
Right now my symptoms are kinda on vacation (woo!), but when they’re giving me trouble, which is most of the time, they definitely interfere with my day to day life.

I once asked my former therapist if I have PTSD and he said no, because I don’t have all of the symptoms and the symptoms I do have aren’t bad enough. However, he did say I have post traumatic growth. More on that here.

Of course my opinion means next to nothing since I don’t have a PhD in psychology like he does, but once I look through this criteria I totally agree with him. I don’t have all of the symptoms and the symptoms I do experience don’t affect my life drastically on most days. It’s more of an inconvenience and annoyance most of the time. But that’s easy to say right now when my symptoms are giving me a much needed break.

TLDR: I have some but not all of the symptoms of PTSD, and luckily I just discovered there’s a name for that: subthreshold PTSD.

Important Definitions

- Sexual assault: any unwanted/non-consensual sexual activity. More information here.
- Rape: Sexual assault involving penetration.
- Consent: affirmative, sober, voluntary, unambiguous, verbal permission to engage in a specific sexual activity at a certain time. It can be withdrawn at any time and cannot be assumed under any circumstances. More information here.
- Trigger: anything that reminds a person of a traumatic memory in someone who has experienced trauma, often related to the five senses. They can cause flashbacks, anxiety, feeling disconnected, anger, feeling defensive, tenseness, feeling negative thoughts, etc. More information here.
- Rape Culture: a culture in which rape is pervasive and normalized due to societal attitudes about gender and sexuality. Examples here.